Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA 94143, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA.
Mil Med. 2023 Nov 3;188(11-12):e3591-e3598. doi: 10.1093/milmed/usad216.
Use rates of cannabis, a substance associated with a host of comorbid physical and mental health concerns, continue to rise for military veterans. Despite this prevalence, descriptive patterns of use among veterans and research on treatment factors that predict cannabis outcomes are lacking. This study aimed to conduct a descriptive profile of veterans who endorse cannabis use, compare veterans endorsing cannabis use to those who do not endorse use, and investigate what factors (other substance use, psychiatric symptoms, and treatment outcomes) predicted return to cannabis use following residential treatment.
The study was a secondary data analysis of a longitudinal sample of U.S. military veterans (N = 200, 193 males, Mage = 50.14, SD = 9) participating in residential substance use disorder treatment through a Veterans Affairs medical center. Interview, survey, and electronic health data were collected over 12 months. Analyses included descriptive and frequency statistics to identify patterns in cannabis use behaviors and motives, independent t-tests to examine differences between the cannabis-using group and non-using group, and a series of univariate logistic regressions to examine potential predictors for cannabis use after treatment discharge.
Lifetime cannabis use was common among veterans (77.5%), and 29.5% reported use during the study. On average, veterans had made one quit attempt before treatment entry. Veterans who endorsed cannabis use consumed more alcohol in the past 30 days at baseline and reported less impulse control and less confidence in maintaining abstinence at discharge. Length of stay in the residential program and no diagnosis of Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV cannabis use disorder criteria predicted post-treatment cannabis use such that veterans who remained in the program longer were more likely to abstain from cannabis use following treatment, and those who did not meet DSM-IV cannabis use disorder criteria were more likely to use following treatment.
Identification of relevant risk factors and treatment processes, such as impulse control, confidence in treatment, and length of stay in treatment, provides practical recommendations for future intervention efforts. This study calls for further examination of cannabis use outcomes among veterans, particularly those participating in substance use treatment.
大麻是一种与许多身体和心理健康问题相关的物质，其使用量继续在退伍军人中上升。尽管这种情况普遍存在，但退伍军人使用大麻的描述性模式以及预测大麻结果的治疗因素的研究仍然缺乏。本研究旨在对使用大麻的退伍军人进行描述性分析，比较使用大麻的退伍军人和不使用大麻的退伍军人，并调查哪些因素（其他物质使用、精神症状和治疗结果）预测了住院治疗后重新使用大麻。
这项研究是对美国退伍军人（N=200，193 名男性，Mage=50.14，SD=9）参加退伍军人事务部医疗中心的住院药物滥用治疗的纵向样本的二次数据分析。通过访谈、调查和电子健康数据在 12 个月内收集。分析包括描述性和频率统计，以确定大麻使用行为和动机的模式，独立 t 检验以检查使用大麻组和不使用大麻组之间的差异，以及一系列单变量逻辑回归，以检查治疗出院后大麻使用的潜在预测因素。
终身大麻使用在退伍军人中很常见（77.5%），29.5%的人在研究期间使用。平均而言，退伍军人在治疗前尝试过一次戒烟。在基线时，使用大麻的退伍军人在过去 30 天内饮酒量更多，在出院时冲动控制能力和保持禁欲的信心更低。住院治疗项目的住院时间和没有诊断出《精神障碍诊断与统计手册》（DSM-IV）大麻使用障碍标准预测了治疗后的大麻使用，即住院时间较长的退伍军人在治疗后更有可能戒除大麻，而没有符合 DSM-IV 大麻使用障碍标准的退伍军人在治疗后更有可能使用大麻。
识别相关的风险因素和治疗过程，如冲动控制、对治疗的信心和治疗时间的长短，为未来的干预措施提供了实际建议。本研究呼吁进一步研究退伍军人中使用大麻的结果，特别是那些参加药物滥用治疗的退伍军人。
